title: Prolonged peripheral nerve blockade in patients using lithium carbonate.
abstract: Peripheral nerve blocks with local anaesthesia are routinely utilized in oral surgical procedures to achieve anaesthesia at the operative site. A number of local tissue factors as well as systemic conditions and medications may alter the onset, depth and duration of peripheral nerve blocks. This article describes two cases of extremely prolonged anaesthesia in patients treated with chronic oral lithium carbonate who had been administered inferior alveolar, lingual, long buccal, greater palatine and posterior superior alveolar nerve blocks with lidocaine with adrenaline for surgical removal of an upper and a lower third molar tooth. A possible relation with systemic lithium therapy and its probable mode of action are explored.
authors.affiliation: Department of Oral and Maxillofacial Surgery (Head: Dr. H.G. Jagadeesh), School of Dental Sciences, Sharda University, Knowledge Park 3, Greater Noida, Uttar Pradesh 201308, India. Electronic address: pavanpatil2000@yahoo.co.uk.
authors.forename: Pavan Manohar
authors.initials: PM
authors.lastname: Patil
mesh_terms: D000328:Adult; D000762:Anesthesia Recovery Period; D000779:Anesthetics, Local / Q000008:administration & dosage / Q000009:adverse effects; D000928:Antidepressive Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001714:Bipolar Disorder / Q000188:drug therapy; D003866:Depressive Disorder / Q000188:drug therapy; D004347:Drug Interactions; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006987:Hypesthesia / Q000209:etiology; D008012:Lidocaine / Q000008:administration & dosage / Q000009:adverse effects; D008036:Lingual Nerve / Q000187:drug effects; D016651:Lithium Carbonate / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D008340:Mandibular Nerve / Q000187:drug effects; D008442:Maxillary Nerve / Q000187:drug effects; D008875:Middle Aged; D008964:Molar, Third / Q000601:surgery; D009407:Nerve Block / Q000009:adverse effects*; D011183:Postoperative Complications; D014081:Tooth Extraction / Q000379:methods; D014095:Tooth, Impacted / Q000601:surgery
chemical_list: D000779:Anesthetics, Local; D000928:Antidepressive Agents; D016651:Lithium Carbonate; D008012:Lidocaine
keywords: Anaesthesia; Duration; Lithium; Nerve blockade